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U.S. Department of Health and Human Services

Tobacco Products

The Changing Landscape of Youth Tobacco Use


The Changing Landscape of Youth Tobacco Product Use infographic thumbnailCTP is committed to a science-based approach that addresses the public health issues associated with tobacco use. That’s why we are collaborating with CDC’s Office on Smoking and Health (OSH) on the only nationally representative survey of middle and high school students that focuses exclusively on tobacco use – the National Youth Tobacco Survey (NYTS).


Determining Trends in Youth Tobacco Use

In 2012, FDA and CDC introduced questions to the survey related to FDA’s regulatory authority, including more detailed information on:

  • the use of non-conventional (e.g., e-cigarettes, hookah) tobacco products,
  • curiosity about cigarettes, cigars, and smokeless tobacco,
  • tobacco dependence symptoms,
  • quitting intentions and behaviors around all tobacco products,
  • harm perceptions of conventional and non-conventional products, and
  • awareness and perception of product warning labels.

Through this partnership, CDC and FDA are conducting the NYTS annually in order to identify emerging trends sooner and meet our nation’s public health goals.


Delving Deeper into the Data

On July 17, 2014, the American Journal of Preventive Medicine (AJPM) published a special FDA-funded supplement disclaimer icon online focusing on data from the 2012 NYTS. The findings highlight the changing landscape of tobacco product use among U.S. middle and high school students, and underscore a growing public health concern around use of non-cigarette tobacco products by youth, as well as the role of addiction in adolescent tobacco use. The supplement contains eight peer-reviewed papers all authored by scientists from FDA, NIH and/or CDC accompanied by three invited commentaries.


Key Findings
In 2012:

  1. Tobacco Use and Marketing
    • Nearly one in 15 U.S. middle school students (790,000) and one in four U.S. high school students (3,540,000) were current tobacco users.
    • The majority of middle and high school students who had used tobacco in the past 30 days (57.9 percent) reported using more than one product.  
    • Youth continue to be exposed to tobacco promotions, including direct mail coupons.  Tobacco marketing helps increase curiosity in tobacco products.
  2. Cigars
    • After cigarettes, cigars were the most widely used tobacco product among youth. Almost 40 percent of non-Hispanic black high school students (39.4 percent) reported ever having smoked cigars.
    • About one in five middle school and high school students who had never used tobacco products were curious about the use of cigars. Curiosity about tobacco products is a predictor of future susceptibility, experimentation, and regular use.
  3. Hookah
    • Nearly half of all middle and high school students (41.2 percent) reported being aware of hookah.  Prevalence of ever (8.9% or 2.3 million students) and current hookah use (3.6% or 940,000) exceeded e-cigarette use.
  4. E-cigarettes
    • Half of middle and high school students (13.1 million) were aware of e-cigarettes, 6.8 percent (1.8 million) had ever used e-cigarettes, and 2.1 percent (550,000) reported having used e-cigarettes in the past thirty days.
    • One in three students perceived e-cigarettes as being less harmful than conventional cigarettes and these students were more likely to have used e-cigarettes.
  5. Tobacco Dependence
    • Symptoms of tobacco dependence can arise even among recent-onset and intermittent adolescent users.  Among middle and high school cigarette, cigar, and smokeless tobacco users, more than half (52.2 percent) reported at least one symptom of tobacco dependence, representing 2.1 million students.
    • Those students who reported dependence symptoms were likely to:
      • be female
      • to have started using tobacco at an earlier age
      • to report use of more than one type of tobacco product, and
      • to use tobacco at a higher frequency.
  6. Quitting Intention and Behavior
    • Over half (52.8 percent) of middle and high school students who reported  having used tobacco in the past 30 days were seriously thinking about quitting the use of all tobacco products—and a similar proportion (51.5 percent) reported failing to quit after having tried during the last year.
  7. Exposure to Warning Labels
    • Today’s health warnings on cigarettes and smokeless products are not noticed by middle and high school students.


Read the Articles


Using Research to Inform Tobacco Product Regulation

Scientific research is critical to CTP’s mission of reducing the disease and death resulting from tobacco use. These latest findings only serve to strengthen existing scientific evidence that can serve to inform regulation of tobacco products.